Law of Unintended Consequences Hits Battle Against Opioid Misuse

By Steve Barrett
Friday, November 1, 2019

If fighting opioid misuse feels like a game of whack-a-mole, you’ve been paying attention.

Fears about misuse have given rise to concerns about too-restrictive policies that could leave patients in unnecessary pain. For example, the American Academy of Family Physicians states on its website: “Creating additional prescribing barriers for primary care physicians would limit patient access when there is a legitimate need for pain relief.”

Now, efforts to stem opioid misuse have been linked to a surge in hepatitis C infections. The reformulation of OxyContin in recent years, intended to make abuse more difficult, spurred many drug abusers to shift to injectable heroin, according to a study in Health Affairs.

A key finding of the research: In states that had higher-than-average rates of OxyContin misuse before the drug was reformulated, hepatitis C infections after the reformulation rose three times faster than in other states.

“These results show that efforts to deter misuse of opioids can have unintended, long-term public health consequences,” says David Powell, lead author and a Senior Economist at the research organization Rand Corp., in a news release regarding the findings. “As we continue to develop policies to combat the opioid epidemic, we need to be careful that new approaches do not make another public health problem worse.”